Quality standard
Quality statement 2: Light protection
Quality statement 2: Light protection
Quality statement
Preterm and term babies who are prescribed neonatal parenteral nutrition receive it through bags, infusion sets and syringes that are protected from light.
Rationale
Parenteral nutrition solutions need to be protected from light to help prevent potentially harmful photo-degradation and oxidation. This ensures that the solution maintains its nutritional levels and is safe to use. It is important to protect the syringes and infusion sets during use as well as protecting the bags of parenteral nutrition solution at all times.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
a) Evidence of local arrangements that ensure that light protection is available for bags, syringes and infusion sets of parenteral nutrition solutions.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, procurement and stock records.
b) Evidence of local arrangements and written clinical protocols to ensure that units that give neonatal parenteral nutrition use light protection.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example, copies of neonatal parenteral nutrition delivery protocols and standard operating procedures.
Outcome
Number of light exposure incidents while giving neonatal parenteral nutrition.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from incident reporting and patient records.
What the quality statement means for different audiences
Service providers (such as neonatal and paediatric units and pharmacy services) ensure that light protection for bags, syringes and infusion sets of parenteral nutrition solutions is available, and that staff are trained to use it. This includes setting infusion pumps correctly depending on the line being used to deliver the parenteral nutrition. They ensure that neonatal parenteral nutrition bags are protected from light when they are stored and that the bags, syringes and infusion sets are protected when neonatal parenteral nutrition is being given.
Healthcare professionals (such as neonatal and paediatric consultants, nurses and pharmacists) are trained to use light protection for bags, syringes and infusion sets of parenteral nutrition solutions, including setting infusion pumps correctly depending on the line being used. They ensure that the neonatal parenteral nutrition bags are protected from light at all times and the syringes and infusion sets are protected when neonatal parenteral nutrition is being given.
Commissioners (such as clinical commissioning groups, integrated care systems and NHS England) ensure that they commission services that have systems in place to administer neonatal parenteral nutrition safely.
Newborn babies who need to be given nutrition directly into their bloodstream through a vein (intravenously) are given nutrition that is protected from light. Protecting the bags of nutrition and the tubes and syringes used to give it from light helps to ensure that the nutritional levels are maintained, and it is safe to use.
Source guidance
Neonatal parenteral nutrition. NICE guideline NG154 (2020), recommendation 1.2.3
Definitions of terms used in this quality statement
Neonatal parenteral nutrition
Nutrition given directly into the bloodstream through a vein (intravenously) in newborn babies who cannot take adequate milk feeds because they are too small or very unwell. It includes nutrients such as amino acids, glucose, fat, electrolytes, vitamins and trace elements. The neonatal period is defined as up to 28 days after birth for babies born at term and 28 days after their due birth date for those born preterm. [Adapted from NICE's guideline on neonatal parenteral nutrition and expert opinion]